Pharm practice questions
1. A client asks you about the difference between a generic drug and a trade- or brand-name drug.
Which of the following are true regarding generic drugs? (SATA)
a. Have the potential for abuse and dependence
b. Have the same chemical composition as the brand-name drug
c. May have several brand names
d. May have several generic names
e. Are usually less expensive than a brand-name drug
2. A client with glaucoma asks you about taking oxybutynin, a muscarinic antagonist, to manage an
overactive bladder. You explain that glaucoma is a contraindication for taking oxybutynin.
Primary care providers should not prescribe contraindicated drugs because of their potential for
which of the following?
a. Serious adverse reactions
b. Drug tolerance
c. Drug dependence
d. Interactions with other drugs
3. You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relieve
a client’s postoperative pain. Which of the following actions describes the action of a agonist on
a receptor?
a. Destroys the receptor
b. Competes with the receptor
c. Activates the receptor
d. Blocks the receptor
4. A client who has a peanut allergy comes to the emergency department with suspected
anaphylactic shock. Which of the following actions should you anticipate taking? (SATA)
a. Initiate oxygen therapy to support respiratory function
b. Administer epinephrine to increase blood pressure
c. Give diphenhydramine to stop histamine release
d. Establish and maintain an open airway to ensure oxygenation
e. Administer a drug agonist to neutralize the allergic reaction
5. You are talking with a client about taking tetracycline along with an antacid. You tell the client
not to take these two drugs at the same time because the antacid can reduce the absorption of
tetracycline. When one drug reduces the effect of another drug, it is
a. An allergic reaction
b. A synergistic effect
c. An antagonistic effect
d. An adverse reaction
6. Primary care providers prescribe drug dosages for children using which of the following
information? (SATA)
a. Body surface area
b. Age
c. Weight
d. Developmental level
e. Drug properties
7. An older client may be at risk for drug toxicity due to which of the following physiologic changes
associated with aging?
a. Reduced hepatic blood flow
b. Increased glomerular filtration rate
c. Reduced body fat
d. Increased gastric motility
8. You are helping a client learn how to give himself an insulin injection. Which of the following is
the best method for evaluating effective learning?
a. Verbally quiz a family member
b. Instruct the client to complete a written test
c. Have the client demonstrate an insulin injection
d. Ask the client several key questions about the procedure
9. A nurse is preparing to administer a drug to a client. In which of the following sections of a drug
handbook should the nurse look to determine if the drug has more than one use?
a. Adverse effects
b. Indications
c. Pharmacokinetics
d. Nursing Implications
10. A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney
disease. The handbook states that the drug can be administered but identifies certain risks.
Which of the following terms describes these risks?
a. Contraindication
b. Precaution
c. Paradoxical effects
d. Adverse effects
11. A nurse is caring for a client who is taking diphenhydramine for insomnia and reports
drowsiness. The nurse should identify that drowsiness indicates which of the following?
a. Therapeutic effect
b. Adverse reaction
c. Contraindication
d. Precaution
12. A nurse is providing teaching for a client who has a new prescription for a drug with a high
potential for toxicity. Which of the following information should the nurse include? (SATA)
a. Periodic laboratory tests are essential to measure serum drug levels
b. Monitoring for indication of toxicity is important
c. Taking the drug with an inducing agent will increase the possibility of toxicity
d. Taking the smallest effective dose is crucial
e. Increasing fluid intake is recommended to avoid toxicity
13. A nurse is providing teaching to a pregnant client who is taking captopril, an ACE
inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic
drug. The nurse should explain that teratogenic drugs can cause which of the following?
a. maternal bleeding
b. maternal blood clots
c. gestational diabetes mellitus
d. fetal malformation
14. When reviewing a list of drugs in a drug handbook, a nurse can identify the generic
names for a drug in which of the following ways?
a. it begins with a lower-case letter
b. it is listed in parentheses along with the trade name
c. there are both letters and numbers in the name
d. the chemical name is listed in parenthesis before the generic name
15. nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same
class share which of the following similarities?
a. they have similar mechanisms of actions
b. they have the same half-life
c. they are administered by the same route
d. they have the similar availability
16. A nurse is caring for a client who is newly admitted to the facility for chest pain. At which
of the following times should the nurse begin teaching about drugs and discharge
planning?
a. after the client has a definitive diagnosis
b. on the days of discharge
c. when the clients family members are present
d. as soon as possible
17. A nurse is caring for a client who is taking acetaminophen and codeine for pain relief.
These analgesics drugs interact with one another to cause an additive effect. The nurse
should identify that which of the following are characteristics of additive drug
interactions? (Select all that apply.)
a. clients can achieve desired effects with the use of lower dosages
b. taking the two drugs together can reduce the effects of one or both drugs
c. taking the two drugs together can potentiate the effects of one of both drugs
d. the two drugs can produce an action neither would have produced alone
e. both drugs have similar actions
18. A nurse is caring for a client who arrived at an emergency department following a bee sting.
Which of the following indicates an anaphylactic reaction? (Select all that apply.)
a. low blood pressure
b. wheezing
c. bradycardia
d. peripheral edema
e. difficulty swallowing
19. A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse
should identify that which of the following factors can decrease the client's ability to learn?
(Select all that apply.)
a. Impaired cognitive level
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b. language barrier
c. discomfort
d. repetition of teaching
e. unreadiness to learn
A nurse is teaching a client about the adverse effects of digoxin. Which of the following
statements should the nurse include in the teaching?
a. "adverse effects are the intended effects of the medications"
b. "adverse effects indicate a severe allergy to the medication."
c. "decrease your medication dose if adverse affects occur."
d. "contact your provider if adverse effects occur.”
A nurse is obtaining a client's health history. The client reports no allergies but has
experienced mild itching while taking amoxicillin in the past. Which of the following
responses should the nurse make?
a. "itching is an expected adverse effect of amoxicillin."
b. "itching can indicate amoxicillin toxicity."
c. "itching can indicate a hypersensitivity to amoxicillin."
d. "itching can result from dry skin, which is often caused by amoxicillin."
A nurse is caring for a client who was prescribed an antidepressant based on its ability
to prevent the reuptake of neurotransmitters. The nurse should identify that which of the
following terms describes why this drug was prescribed for the client?
a. pharmacologic action
b. chemical stability
c. route
d. adverse effects
A nurse is caring for a client who has a history of renal insufficiency and is taking lithium. The
nurse should monitor the client for which of the following?
a. tolerance to the drug
b. drug interaction
c. drug toxicity
d. dependence on the drug
A nurse is teaching a client who has a prescription for a drug that has a receptor agonist
effect. Which of the following information should the nurse include in the teaching?
a. "this will increase the effects of normal cellular functions."
b. "this prevents cells in your body from performing certain actions."
c. "this prevents hormones in your body from attaching to cell receptor sites."
d. "this minimizes the risk that the medications you take will become toxic."
A nurse is preparing to administer a drug to a client. In which of the following sections of a drug
handbook should the nurse look to determine if the client can receive the drug?
a. adverse effects
b. contraindications
c. implementation
d. black box warning
A nurse is caring for a client who is postpartum and breastfeeding. The client asks the
nurse about the effects that taking over-the-counter drugs will have on her newborn.
Which of the following should the nurse consider when recommending a drug for the
client? (Select all that apply.)
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a. the newborns weight
b. how much breast milk the newborn consumes each day
c. whether or not the benefits to the client outweigh the risks to the newborn
d. the properties of the drug
e. the route of administration of the drug
A nurse is caring for a client who has a new prescription for a drug. After receiving the
first dose of the drug, the client experiences anaphylaxis. The nurse should identify that
anaphylaxis represents which of the following results of the drug?
a. adverse effect
b. paradoxical effect
c. therapeutic effect
d. toxicity
A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit
juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used
to metabolize sertraline. The nurse should recognize that client's risk for which of the
following?
a. reducing drug absorption
b. drug dependence
c. altered drug distribution
d. drug toxicity
A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral
form of the drug. The nurse should identify that the oral dose will be hight than the IV
dose for which of the following reasons?
a. the IV form crosses the blood-brain barrier
b. the oral form has a decreased half life
c. the oral form has decreased bioavailability because of the first-pass effect
d. the oral form has an increased rate of excretion
A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing
teaching, the nurse should review the precautions section of a drug handbook for which
of the following reasons?
a. to determine drug-food interactions
b. to determine if dosage modification is indicated
c. to determine how the drug is absorbed
d. to determine availability
A nurse is teaching a client about naproxen enteric-coated tablets. Which of the
following statements should the nurse include in the teaching?
a. "drug absorption occurs in the stomach."
b. "you should expect immediate absorption of the drug."
c. "you should allow the tablet to dissolve in you mouth."
d. "do not crush or chew tablet."
A nurse is obtaining a client's health history and discovers that the client takes
loratadine, and over-the-counter drug. The nurse should identify that which of the
following is correct regarding over-the-counter drugs? (Select all the apply.)
a. they do not require the supervision of a nurse
b. they can interact with other drugs
c. they should be included in the clients drug history assessment
d. they are less effective than prescription drugs
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e. they do not cause toxicity
A nurse is caring for a client who is having difficulty remembering to take their prescribed
drug three times a day. The nurse should identify that which of the following alternate
forms of the drug can help to promote adherence to the prescribed dosage?
a. liquid suspension
b. immediate-release capsule
c. extended-release tablet
d. powder form
Recognizing the potential for a drug interaction between the diuretic, furosemide (Lasix), and
the cardiac glycoside, digoxin (Lanoxin), the provider should plan to monitor the patient for
which of the following?
A) Hyperkalemia
B) Ototoxicity
C) Digoxin toxicity
D) Hypoglycemia
Digoxin (Lanoxin) is effective in treating heart failure due to which of the following
pharmacological actions? (Select all that apply.)
A) Exerts positive inotropic action
B) Decreases cardiac output
C) Decreases sympathetic tone
D) Increases vascular constriction
E) Increases myocardial contractility
A patient who began drug therapy reports palpitations the following day. His ECG
indicates frequent premature ventricular contractions. The provider prescribes a stat
dose of lidocaine (Xylocaine) 50 mg via IV bolus. You should monitor the patient for
which of the following adverse reactions?
A) Metabolic alkalosis
B) Hypertension
C) Tachycardia
D) Paresthesias
A primary care provider prescribes captopril (Capoten) to treat a patient's hypertension
and also help alleviate his heart failure. The provider should make sure the patient
understands that he should not take which of the following over-the-counter drugs while
taking captopril?
A) Ibuprofen (Motrin)
B) Acetaminophen (Tylenol)
C) Calcium carbonate (Tums)
D) Diphenhydramine (Benadryl)
The provider prescribes quinidine gluconate (Quinaglute Dura-tabs) as an oral
antidysrhythmic agent. You should question the use of quinidine for a patient taking
digoxin (Lanoxin) due to a possible drug interaction that can result in which of the
following?
A) Liver toxicity
B) Quinidine toxicity
C) Digoxin toxicity
D) Cardiotoxicity
39. A patient is taking bumetanide (Bumex) and spironolactone (Aldactone). You should explain that
using the drugs together may reduce the risk of which of the following adverse effects?
A) Hypokalemia
B) Hyponatremia
C) Hyperglycemia
D) Hypochloremia
40. A patient is about to begin taking hydrochlorothiazide (Microzide) for hypertension. To assess
for adverse effects of the drug, you should monitor for which of the following? (Select all that
apply.)
A) Ototoxicity
B) Hyponatremia
C) Hypokalemia
D) Dehydration
E) Hypoglycemia
41. You are administering lidocaine, 50 mg via IV bolus, to a client with a ventricular dysrhythmia.
You monitor the client for which adverse reactions to lidocaine?
a. Metabolic alkalosis
b. Hypertension
c. Tachycardia
d. Paresthesia
42. While talking with a client who is taking captopril to treat hypertension, which instructions do
you include to help her manage the drug’s adverse effects?
a. Check your heart rate prior to taking the drug
b. Wear sunscreen and protective clothing while outdoors
c. Do not use salt substitutes to season your food
d. Take the drug with a meal
43. A patient taking losartan (Cozaar) for hypertension asks about stopping contraception and
starting a family. You should inform the patient that losartan is unsafe to take during pregnancy
due to which of the following risks?
A) Macrosomia
B) Fetal injury
C) Gestational diabetes
D) Thromboembolic disease
44. A patient is about to begin taking aliskiren (Tekturna) to treat hypertension. Which of the
following should you tell the patient to avoid to ensure optimal absorption of this drug?
A) Soy sauce
B) Green, leafy vegetables
C) Fatty foods
D) Foods high in carbohydrates
45. A nurse is reviewing new prescriptions with a client who has heart disease. The nurse should
instruct the client that which of the following drugs is prescribed to treat hypercholesterolemia?
A. Simvastatin
B. Furosemide
C. Losartan
D. Nitroglycerin
46. A nurse is caring for a client who is taking carvedilol and has a prescription for an oral
antidiabetic drug to manage their new diagnosis of type 2 diabetes mellitus. By taking
both drugs concurrently, the nurse should identify that the client is at an increased risk
for which of the following conditions?
A. Hyperglycemia
B. Bradycardia
C. Hypotension
D. Hypoglycemia
47. A nurse should identify that which of the following drugs is used only for the short-term
treatment of a cardiac dysrhythmia because of the serious adverse effects associated with longterm use?
A. Quinidine
B. Procainamide
C. Nitroglyceride
D. Verapamil
48. A nurse is caring for a client who has a new prescription for verapamil to treat atrial
fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while
taking verapamil because it can cause the client to experience which of the following
conditions?
A. Tachycardia
B. Dehydration
C. Diarrhea
D. Hypotension
49. A nurse should recognize that milrinone is contraindicated for a client who has which of the
following conditions?
A. Acute myocardial infarction
B. Peripheral vascular disease
C. Ulcerative colitis
D. Ventricular tachycardia
50. A nurse is teaching a client who has a new prescription for quinidine. Which of the
following statements should the nurse include?
A. "Monitor your pulse rate and report changes."
B. "Remain upright for 30 minutes after taking this medication."
C. "This medication can decrease digoxin levels."
D. "This medication can cause urinary incontinence."
51. A nurse is caring for a client who has a new prescription for aliskiren to treat hypertension. The
nurse should monitor the client for which of the following findings as an adverse effect of the
drug? (Select all that apply).
A. Hyperkalemia
B. Throat swelling
C. Constipation
D. Cough
E. Joint pain
52. A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should
instruct the client that which of the following manifestations is a potential adverse effect of this
drug?
A. Headache
B. Constipation
C. Hypertension
D. Hyperglycemia
53. A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse
should recognize that which of the following client laboratory values requires immediate
intervention?
A. Sodium 140 mEq/L
B. Potassium 5.2 mEq/L
C. Chloride 100 mEq/L
D. Magnesium 1.9 mEq/L
54. A nurse is caring for a client who will begin using transdermal nitroglycerin to treat
angina pectoris. When speaking to the client about the drug, which of the following
instructions should the nurse include? (Select all that apply).
A. "Apply a new patch at the onset of anginal pain."
B. "Apply the patch to dry skin and cover the area with plastic wrap."
C. "Apply the patch to a hairless area and rotate sites."
D. "Apply a new patch when you start your day."
E. "Remove patches for 10 to 12 hours each day."
55. A nurse is caring for a client who has a new prescription for propranolol to treat a
tachydysrhythmia. The nurse should instruct the client to avoid taking which of the
following types of over-the-counter drugs while taking propranolol?
A. Antihistamines
B. Potassium supplements
C. NSAIDs
D. Vitamin C
56. A nurse is caring for a client who is taking digoxin and develops changes on their ECG
tracing and other manifestations that indicate the client has severe digoxin toxicity.
Which of the following drugs should the nurse expect to administer to treat this
complication?
A. Acetylcysteine
B. Flumazenil
C. Antigen-binding fragments
D. Deferoxamine
57. A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the
following should the nurse instruct the client to avoid while taking this drug?
A. Grapefruit juice
B. Milk
C. Foods high in vitamin K
D. NSAIDs
58. A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify
the prescription with the provider if the client has a history of which of the following conditions?
A. Migraine headaches
B. Pancreatitis
C. Second-degree AV block
D. Angina pectoris
59. A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready,
irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that
these manifestations indicate which of the following adverse effects?
A. Hypokalemia
B. Hypoglycemia
C. Hypouricemia
D. Hyponatremia
60. A nurse is caring for a client who has a depressive disorder and requires a prescription drug to
treat hypertension. The nurse should recognize that which of the following antihypertensive
drugs is contraindicated for this client?
A. Reserpine
B. Captopril
C. Hydralazine
D. Eplerenone
61. A nurse is administering hydrochlorothiazide to a client who has gouty arthritis. The nurse
should monitor the client for which of the following findings that indicates an adverse effect of
this drug?
A. Hyperuricemia
B. Hypernatremia
C. Hyperkalemia
D. Hypoglycemia
62. A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to
include which of the following foods in their diet to increase potassium intake?
A. Raisins
B. Cabbage
C. Cheese
D. Eggs
63. A nurse is providing teaching to a client who has a new prescription for losartan to treat
hypertension. The nurse should instruct the client that which of the following findings
could indicate an adverse reaction to the drug and needs to be reported?
A. Facial edema
B. Sleepiness
C. Peripheral edema
D. Constipation
64. A nurse is caring for a client who has a new prescription for dobutamine. The nurse should
clarify the prescription with the provider if the client is receiving which of the following types of
drugs? (Select all that apply).
A. ACE inhibitor
B. MAOI
C. General anesthetic
D. Tricyclic antidepressant
E. Beta blocker
65. A nurse is caring for a client who is taking atorvastatin and has a new prescription for
gemfibrozil. The nurse should recognize that this drug combination places the client at
an increased risk for which of the following adverse effects?
A. Myopathy
B. Hypoglycemia
C. Irregular pulse
D. Kidney failure
66. A nurse is teaching a client who has a new prescription for gemfibrozil. Which of the
following instructions should the nurse include? (Select all that apply).
A. Take the drug with food
B. Report any new intolerance to fried foods
C. Report muscle tenderness
D. Expect periodic liver function testing
E. Take the drug once each daily
67. A nurse is caring for a client who has a glomerular filtration rate of 10 mL/min and a
reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide for
this client because of which of the following characteristics of the drug?
A. The drug can cause hypoglycemia in clients who have a low urine output.
B. The drug does not reduce blood pressure for clients who have a low urine output.
C. The drug can increase the risk of pulmonary edema for clients who have renal
insufficiency.
D. The drug does not promote diuresis for clients who have renal insufficiency.
68. A nurse is providing teaching to a client who is taking simvastatin. The nurse should
instruct the client to report which of the following manifestations as an indication of a
serious adverse reaction that could require discontinuing drug therapy?
A. Bronchoconstriction
B. Muscle pain
C. Lip numbness
D. Somnolence
69. A nurse is caring for a client who is about to begin captopril therapy. Which of the
following adverse effects should the nurse instruct the client to report because it can
indicate a need to discontinue drug therapy? (Select all that apply).
A. Rash
B. Distorted taste
C. Swelling of the tongue
D. Photosensitivity
E. Dry cough